Just take a minute to answer the quick questions below to be in with a chance of winning 12 months protection with any Assist Protect cover product you want!

• If you're a winner, we'll email you immediately with a 100% discount code you can use to claim your prize
• Prize draw entry is only available to current Total Motor Assist members
• One name is drawn randomly on the last working day of every month

Your first name:

Your surname:

Your email:

How did you hear about us?

Would you recommend us to people you care about?

Yes No

Do you own a home?

Yes No

Do you or anyone in your family cycle?

Yes No

Do you or anyone in your family drive a van?

Yes No

Do you or anyone in your family ride a motorbike?

Yes No

If your name is drawn, which free product would you like?

Anything else you'd like to tell us - e.g. suggestions of how you think we could improve?

Assist Protect Ltd is regulated by the Data Protection Act 1998 and is registered with the Information Commissioner's Office under registration reference Z2148051.

Assist Protect Ltd is an appointed agent of One-Stop-Law Limited who are regulated by the Claims Management Regulator in respect ofregulated claims management activities under Authorisation Number CRM27266, details of which can be found at www.claimsregulation.gov.uk